Neonatologist Talk

One doc down...two or three to go.  The neonatologist (doctor responsible for the well-being of Karsie) just came in and sat down patiently with us to answer a ton of questions regarding the delivery and afterwards.  We will list a bunch of things we can remember, but we were able to get a few more questions answered:

-Obviously the longer we go in the pregnancy the better.  He did say that 31 weeks is definitely doable, but he did give us a realistic approach to that scenario.  Basically the longer that we go now the shorter time she will be in ICU.  If we delivered now she could be in past the end of September because she would need to be on a breathing tube, feeding tube, etc. waiting for everything to work.  

-Getting Bob back into Karsie's stomach can be a balancing act.  The biggest concern in breathing.  If they just crammed everything back in, her lungs might not be able to hold all of that pressure since her stomach has not been growing with the organs (giving there less space inside for her soon-to-be organs.  Therefore, when they put the organs in it pushes up the diaphragm and creates stress on the lungs.  They will need to decide whether she can handle all of it going in at once or doing stages where they put some of Bob back in her abdomen and then wait a while for her to adjust.

-The other part of that balancing act is trying to time the surgery.  While they will probably keep some of Bob outside after putting some in, they do not want to keep all of Bob out for a long time as there is an increased risk of infection.  Unfortunately that's just a worry that will not be resolved until it's resolved.

-The most heartbreaking news we received was that it is very unlikely that Michelle will get to hold Karsie before she goes into surgery.  Kevin will be following her to surgery while Reva (hopefully the doctors let us have more than one guest in the room) stays with Michelle.  We wanted Michelle to be able to have skin on skin contact, but it looks like a picture might be all we get.

We are just about to go in to get an ultrasound to talk with our doctor so we should have news later, but the basic understanding here is that this is all adding up to be a complicated matter when we need to bring her into this world.  This is not just an omphalocele to fix, it's not just prematurity to fix, it's not just fluid in the abdomen to fix, it's all of the above.  An omphalocele is one thing when born on time because they can do things to help the breathing, but add on a premature birth with premature lungs and it creates more of a problem....and this is made an issue with the possibility that the fluid in her abdomen moves up close to her heart to create something called hydrops which is when the body is basically breaking down.  If signs of that start to happen then we will have an emergency C-section.  

Pray lots.  Thank you for the ones we have had already!  We love you all.